Pediatric Heart Expert Forum
Borderline Long qt
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Borderline Long qt

My son is 10 years and during a routine EKG my son has a borderline long qt interval at the time he was on zOLOFT and we took him off Zoloft and did several EKG's after 1,2,3 months from withdrawing from meds.  The borderline problem still remained so my son has a complete workup, echo and he wore a halter monitor.  In speaking with his cardiologist he does not want to restrict him from sports but I have a real problem with t his as after having read this board you either have long qT or not there is no such thing as borderline.  We are waiting to see the genetecist and the elctrophysiologist to see how he has this as neither myself or my husband have this and noone in the family has had any symptoms or died early.  I am really concerned as my son is my only child.  In the meantime we have put him back on some meds that are ok to take like Abilify and Lexapro but they have caused a substantial weight gain because he is no longer doing any sports.  Am I doing the right thing in restricting him from any sports.



shaheda  noonan
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Dear nadeem99:  Certainly there are situations where youngsters have “borderline prolonged QTc”.  We face this problem regularly as more and more children get electrocardiograms for various reasons.  Normally the corrected QT interval is less than or equal to 440 milliseconds.  In true prolonged QT syndrome, the corrected QT interval is generally 480 milliseconds or longer.  Thus, the children with corrected QT intervals between 450 and 470 milliseconds are “borderline” prolonged.  Many of these youngsters are actually normal, but fall outside the normal curve.  Some do have true prolonged QT syndrome of the genetic type, but not the typically severely prolonged QTc interval on ECG.  The job of the cardiologist is to determine (as best as possible) if children in the borderline category are normal or abnormal. If your son had a thorough cardiac evaluation and a negative holter monitor (no arrhythmias seen), and there is no family history of arrhythmias, or sudden death and the parents have normal electrocardiograms then it is common to allow normal activities.  I would recommend that you follow through with the genetics and electrophysiology consultations, but if they agree that the typical genetic forms of long QT are not present, then activity restriction does not appear indicated.
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